Siri’s School of the Performing Arts
Student Registration Form
Print this page and send it along
with the $10.00 registration fee and your full first month's tuition to:
|
Siri's School of the
Performing Arts |
|
250 Mercer Street |
|
P.O. Box 606 |
|
Harmony, PA 16037 |
Name________________________
Age ______________________
Date of Birth __________________ Parent’s Name ____________________
Home Phone
# __________________ Work/Emergency
# ________________
Address ____________________________________________________________
City
____________________________ Zip
Code _________________________
Where you heard about us ______________________________________________
Registration
Fee: $10.00 Today's Date ______________________________
(This reserves your space in
class and is non-refundable.)
Class(es)
you are registering for__________________________________________
Any Medical
Conditions We Should Be Aware of? _____________________________
___________________________________________________________________
Notes:
______________________________________________________________
___________________________________________________________________
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